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The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies

BACKGROUND: Numerous studies have attempted to determine the prognostic role of proliferating cell nuclear antigen (PCNA) expression in patients with osteosarcoma with no consistent conclusion. We performed this meta-analysis to systematically elucidate the association in a more precise manner. The...

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Autores principales: Wang, Xing, Wang, Dong, Yuan, Na, Liu, Fanxiao, Wang, Fu, Wang, Bomin, Zhou, Dongsheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662318/
https://www.ncbi.nlm.nih.gov/pubmed/29019895
http://dx.doi.org/10.1097/MD.0000000000008254
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author Wang, Xing
Wang, Dong
Yuan, Na
Liu, Fanxiao
Wang, Fu
Wang, Bomin
Zhou, Dongsheng
author_facet Wang, Xing
Wang, Dong
Yuan, Na
Liu, Fanxiao
Wang, Fu
Wang, Bomin
Zhou, Dongsheng
author_sort Wang, Xing
collection PubMed
description BACKGROUND: Numerous studies have attempted to determine the prognostic role of proliferating cell nuclear antigen (PCNA) expression in patients with osteosarcoma with no consistent conclusion. We performed this meta-analysis to systematically elucidate the association in a more precise manner. The purpose of this meta-analysis is to determine the prognostic role of PCNA in patients with osteosarcoma. METHODS: A systematic search of relevant studies was performed in 6 electronic databases including PubMed, Embase, Web of Science, Wanfang database, China National Knowledge Internet (CNKI) database, and Chinese Biological Medical (CBM) Database (up to March 1, 2016) with the following keywords: (PCNA OR proliferating cell nuclear antigen) AND (osteosarcoma OR osteogenic tumor). A manual search of references on relevant articles was also conducted by 2 investigators independently. We performed a comprehensive evaluation of the correlation between PCNA expression and overall survival (OS) or disease-free survival (DFS) by calculating relative ratios (RR) and their corresponding 95% confidence intervals (CI) using STATA software. A fixed- or random-effect model was chosen based on the between-study heterogeneity. RESULTS: In total, 16 studies with 691 osteosarcoma patients were included in this meta-analysis. PCNA overexpression was found in approximately 57.31% of the patients with osteosarcoma. The meta-analysis suggested that PCNA overexpression in osteosarcoma patients is associated with low OS, but not significantly with DFS (RR = 1.82, 95% CI 1.53–2.18, P = .000; RR = 1.15, 95% CI 0.91–1.44, P = 0.234). Sensitivity analysis for OS and DFS showed no significant difference and the pooled RRs were stable when the included studies were removed one by one. Similar results were also obtained for subgroup analysis based on different follow-ups and cutoffs to determine PCNA expression. CONCLUSION: The findings from this meta-analysis indicate that PCNA overexpression is an effective biomarker for poor prognosis in patients with osteosarcoma for OS. Hence, more large-scale studies are still needed to further warrant this conclusion.
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spelling pubmed-56623182017-11-21 The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies Wang, Xing Wang, Dong Yuan, Na Liu, Fanxiao Wang, Fu Wang, Bomin Zhou, Dongsheng Medicine (Baltimore) 5700 BACKGROUND: Numerous studies have attempted to determine the prognostic role of proliferating cell nuclear antigen (PCNA) expression in patients with osteosarcoma with no consistent conclusion. We performed this meta-analysis to systematically elucidate the association in a more precise manner. The purpose of this meta-analysis is to determine the prognostic role of PCNA in patients with osteosarcoma. METHODS: A systematic search of relevant studies was performed in 6 electronic databases including PubMed, Embase, Web of Science, Wanfang database, China National Knowledge Internet (CNKI) database, and Chinese Biological Medical (CBM) Database (up to March 1, 2016) with the following keywords: (PCNA OR proliferating cell nuclear antigen) AND (osteosarcoma OR osteogenic tumor). A manual search of references on relevant articles was also conducted by 2 investigators independently. We performed a comprehensive evaluation of the correlation between PCNA expression and overall survival (OS) or disease-free survival (DFS) by calculating relative ratios (RR) and their corresponding 95% confidence intervals (CI) using STATA software. A fixed- or random-effect model was chosen based on the between-study heterogeneity. RESULTS: In total, 16 studies with 691 osteosarcoma patients were included in this meta-analysis. PCNA overexpression was found in approximately 57.31% of the patients with osteosarcoma. The meta-analysis suggested that PCNA overexpression in osteosarcoma patients is associated with low OS, but not significantly with DFS (RR = 1.82, 95% CI 1.53–2.18, P = .000; RR = 1.15, 95% CI 0.91–1.44, P = 0.234). Sensitivity analysis for OS and DFS showed no significant difference and the pooled RRs were stable when the included studies were removed one by one. Similar results were also obtained for subgroup analysis based on different follow-ups and cutoffs to determine PCNA expression. CONCLUSION: The findings from this meta-analysis indicate that PCNA overexpression is an effective biomarker for poor prognosis in patients with osteosarcoma for OS. Hence, more large-scale studies are still needed to further warrant this conclusion. Wolters Kluwer Health 2017-10-13 /pmc/articles/PMC5662318/ /pubmed/29019895 http://dx.doi.org/10.1097/MD.0000000000008254 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5700
Wang, Xing
Wang, Dong
Yuan, Na
Liu, Fanxiao
Wang, Fu
Wang, Bomin
Zhou, Dongsheng
The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies
title The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies
title_full The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies
title_fullStr The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies
title_full_unstemmed The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies
title_short The prognostic value of PCNA expression in patients with osteosarcoma: A meta-analysis of 16 studies
title_sort prognostic value of pcna expression in patients with osteosarcoma: a meta-analysis of 16 studies
topic 5700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662318/
https://www.ncbi.nlm.nih.gov/pubmed/29019895
http://dx.doi.org/10.1097/MD.0000000000008254
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